Posted on Mar 27, 2023
A billing dispute means a mom must pay nearly $1,000 a month for her son's diabetes care
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https://www.usatoday.com/story/news/health/2023/03/27/diabetes-treatment-care-cost/ [login to see] /
For Gianluca Cefalo, a new insulin pump has allowed him to reclaim his life.
The 12-year-old boy with Type 1 diabetes no longer visits the school nurse for an insulin shot before lunch. He doesn't worry about his blood sugar spiking or dropping when he sprints on the basketball court. He looks forward to baseball after taking last season off over frustration managing his blood sugar.
But a dispute between his family's health insurer and the company that makes the pump leaves his mom, Maria Chiodi, with a monthly bill of $872. Her family is struggling to afford the technology, she said.
"It's a little absurd to me as to how these two companies can't work together," said Chiodi, who lives in Millwood, New York with her husband and two children. For Gianluca Cefalo, a new insulin pump has allowed him to reclaim his life.
The 12-year-old boy with Type 1 diabetes no longer visits the school nurse for an insulin shot before lunch. He doesn't worry about his blood sugar spiking or dropping when he sprints on the basketball court. He looks forward to baseball after taking last season off over frustration managing his blood sugar.
But a dispute between his family's health insurer and the company that makes the pump leaves his mom, Maria Chiodi, with a monthly bill of $872. Her family is struggling to afford the technology, she said.
"It's a little absurd to me as to how these two companies can't work together," said Chiodi, who lives in Millwood, New York with her husband and two children.
For Gianluca Cefalo, a new insulin pump has allowed him to reclaim his life.
The 12-year-old boy with Type 1 diabetes no longer visits the school nurse for an insulin shot before lunch. He doesn't worry about his blood sugar spiking or dropping when he sprints on the basketball court. He looks forward to baseball after taking last season off over frustration managing his blood sugar.
But a dispute between his family's health insurer and the company that makes the pump leaves his mom, Maria Chiodi, with a monthly bill of $872. Her family is struggling to afford the technology, she said.
"It's a little absurd to me as to how these two companies can't work together," said Chiodi, who lives in Millwood, New York with her husband and two children. For Gianluca Cefalo, a new insulin pump has allowed him to reclaim his life.
The 12-year-old boy with Type 1 diabetes no longer visits the school nurse for an insulin shot before lunch. He doesn't worry about his blood sugar spiking or dropping when he sprints on the basketball court. He looks forward to baseball after taking last season off over frustration managing his blood sugar.
But a dispute between his family's health insurer and the company that makes the pump leaves his mom, Maria Chiodi, with a monthly bill of $872. Her family is struggling to afford the technology, she said.
"It's a little absurd to me as to how these two companies can't work together," said Chiodi, who lives in Millwood, New York with her husband and two children.
A billing dispute means a mom must pay nearly $1,000 a month for her son's diabetes care
Posted from usatoday.com
Medical
Health
Children
Posted 1 y ago
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PO1 William "Chip" Nagel Republicans wouldn't allow ALL insulin users to pay a lower monthly dollar amount.
..."Chiodi initially thought she'd pay the Omnipod's cost for the first two months until she met her insurance plan's $1,500 deductible, which is the amount a person must pay out of pocket for a drug, device or medical service before coverage kicks in.
But because of this dispute, none of her payments have been applied to her insurance plan's deductible.
She filed an appeal with her insurance plan that included a doctor's letter of medical necessity, but the appeal was rejected. She wrote a letter to the board of her husband's union, which sponsors the family's health insurance plan. She also filed a complaint with the New York State Department of Financial Services.
So far, all her efforts to get coverage have failed.
"I have to pay $872 every 30 days because the two organizations – the insurance company and the manufacturer – can't work together on a billing code," she said."...
..."Chiodi initially thought she'd pay the Omnipod's cost for the first two months until she met her insurance plan's $1,500 deductible, which is the amount a person must pay out of pocket for a drug, device or medical service before coverage kicks in.
But because of this dispute, none of her payments have been applied to her insurance plan's deductible.
She filed an appeal with her insurance plan that included a doctor's letter of medical necessity, but the appeal was rejected. She wrote a letter to the board of her husband's union, which sponsors the family's health insurance plan. She also filed a complaint with the New York State Department of Financial Services.
So far, all her efforts to get coverage have failed.
"I have to pay $872 every 30 days because the two organizations – the insurance company and the manufacturer – can't work together on a billing code," she said."...
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PO1 William "Chip" Nagel good day Brother William, always informational and of the most interesting. Thanks for sharing, have a blessed day!
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